336426277-6-16-2020-18-AS-EMAN-BQTVCG-20200622161907

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336426277
Report Date: 06/16/2020
Date Signed: 06/16/2020 04:55:58 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/13/2020 and conducted by Evaluator Robbie Johnson

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20200113100259

FACILITY NAME:	BLISSFUL CANYON HOMECARE		FACILITY NUMBER:	336426277
ADMINISTRATOR:	ROSALINDA ORLEANS		FACILITY TYPE:	740
ADDRESS:	1770 CENTURY AVE.		TELEPHONE:	(951) 295-7097
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92506
CAPACITY:	6	CENSUS: 6	DATE:	06/16/2020
		UNANNOUNCED	TIME BEGAN:	03:38 PM
MET WITH:	Rosalinda Orleans, Administrator		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Facility is providing hospice care without proper authorization
Residents are not provided a comfortable living arrangements
Staff is unable to properly communicate with residents
Staff health conditions poses as risk to residents while in care
Staff speaks inappropriately towards residents while in care
Staff threatened resident with eviction
Staff falsified residents information to authorized representatives

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Robbie Johnson contacted the facility via telephone to deliver findings regarding the above allegations via telephone due to COVID-19. LPA identified herself and discussed the purpose of the call and the elements of the above allegation with Administrator Rosalinda Orleans.

Allegation #1 Facility is providing hospice care without proper authorization. Interviews with the Administrator revealed that the facility has been approved by the Department of Social Services to provide hospice care to residents. A review of documentation confirms that the facility has an approved hospice waiver. The allegation of facility is providing hospice care without proper authorization is UNSUBSTANTIATED.

Allegation #2 Residents are not provided a comfortable living arrangement. Interviews with several residents in the facility revealed that the facility's living arrangements are comfortable and that staff has remained professional in providing services. LPA could not corroborate that residents are not provided a comfortable living arrangement. The allegation is UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Robbie Johnson	TELEPHONE: (951) 248-0304
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 18-AS-20200113100259

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: BLISSFUL CANYON HOMECARE	FACILITY NUMBER: 336426277
	VISIT DATE: 06/16/2020

NARRATIVE

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Allegation #3 Staff is unable to properly communicate with residents. Interviews with several residents revealed that staff has remained professional in executing duties and that residents have been able to communicate with various staff members and the Administrator. Interviews with staff revealed that residents communicate their needs verbally and in writing to staff. LPA could not find evidence that staff is unable to properly communicate with residents. The allegation is UNSUBSTANTIATED.

Allegation # 4 Staff health conditions pose a risk to residents while in care. LPA reviewed the health screening reports for all staff working in the facility. All staff working in the facility have been cleared by a medical professional to perform duties in the facility. LPA could not corroborate that the staff have health conditions that pose a risk to residents while in care. The allegation is UNSUBSTANTIATED.

Allegation # 5 Staff speaks inappropriately towards residents while in care. Interviews with several residents who reside in the facility revealed that staff has remained professional in executing their duties. Interviews with staff revealed that all residents in the facility are treated with dignity and respect. LPA could find no evidence that staff speaks inappropriately towards residents while in care. The allegation is UNSUBSTANTIATED.

Allegation # 6 Staff threatened resident with eviction. Interviews with staff and the Administrator revealed that no resident has been served an eviction in writing or verbally. Interviews with several residents in the facility revealed that no staff has ever served an eviction to them. LPA could find no evidence that staff threatened any resident with an eviction. The allegation is UNSUBSTANTIATED.

Allegation # 7 Staff falsified residents information to authorized representatives. Interviews with the Administrator revealed that no resident information has been falsified. Further interviews with staff revealed that no information provided to any residents family or medical provider has been falsified. LPA could not corroborate that staff falsified any residents information. The allegation is UNSUBSTANTIATED. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged abuse occurred.

A copy of this report was reviewed with and provided the Administrator

SUPERVISOR'S NAME: Efren Malagon	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Robbie Johnson	TELEPHONE: (951) 248-0304
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2020

LIC9099 (FAS) - (06/04)

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